“A number of the proposed stage 3 measures necessitate significant increases in clinical documentation, involve new and potentially complex work flows, are likely to be difficult for many eligible professionals to understand and implement, or depend on technologies that are not yet widely deployed or shown to be usable in busy practices,” said Michael H. Zaroukian, MD, PhD, chair of the American College of Physicians medical informatics committee. -source
The above statement is a clear reflection of what the various ONC committees are trying to achieve with meaningful use.
Let’s take a quick look at some of the meaningful use stage 3 proposed requirements that illustrate how valuable a robust & versatile POC computing system will be in order to meet meaningful use stage 3.
Clinical Decision Support (CDS) at the point of care is one of the challenging meaningful use stage 3 measures. This exists in meaningful use stage 2 as well, but in stage 3 it goes from 5 to 15 CDS interventions. The measure literally says that the 15 CDS interventions or guidance need to be “presented at the relevant point in patient care.”
A critical measure that benefits from a quality information & medication access system at the point-of-care is the eMAR requirement. The measure states, “More than 30% of medication orders created by authorized providers of the eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23) during the EHR reporting period are tracked using eMAR.” Plus, in MU stage 3 you’re required to track mismatches for quality improvement.
There’s a whole suite of other meaningful use stage 3 measures that benefit from point-of-care systems as well. Some of those include: CPOE, ePrescribing, maintaining up-to-date problem and medication lists, and recording electronic notes in patient records. In the case of the problem and medication lists, meaningful use stage 3 requires system recommendations for missed items. It will be hard to verify those recommendations without the patient present. The kicker with recording electronic notes in meaningful use stage 3 is that you have to do so within 4 calendar days. Certainly that doesn’t require you to chart at the point-of-care, but it does start to encourage the idea.
Meaningful use stage 3 is still in the proposal stage, but the items I listed above are unlikely to be taken out of the meaningful use stage 3 final rule. Some of the percentages may be adjusted, but I expect the core requirements will remain in place. Plus, many of the above requirements are also included in meaningful use stage 2.
The real question hospitals will be asking is which point-of-care computing system they should use as opposed to if they should use a point-of-care computing system.
What ways are you using point-of-care solutions to help your organization meet meaningful use?